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Biomedical subjects

E Livni

Publications and source records attributed to E Livni.

At least 37 records · Page 2Linked to original sources
PubMed1996

Pharmacokinetics of [18F]fleroxacin in patients with acute exacerbations of chronic bronchitis and complicated urinary tract infection studied by positron emission tomography.

The pharmacokinetics of fleroxacin, a new broad-spectrum fluoroquinolone, were measured by positron emission tomography (PET) with [18F]fleroxacin in five patients with acute bacterial exacerbations of chronic bronchitis and in five patients with symptomatic, complicated urinary tract infection. Two studies were performed with each patient, one within 24 h of the initiation and one within 24 h of the completion of a 7-day course of fleroxacin, 400 mg/day. For each study, the patient received an infusion of that day's therapeutic dose of fleroxacin (400 mg) supplemented with approximately 740 MBq of [18F]fleroxacin, and serial PET images and blood samples were collected for 6 to 8 h starting at the initiation of the infusion. Between studies, the drug was administered orally. In all infected tissues, there was rapid accumulation of radiolabeled drug, with stable levels achieved within 1 h after completion of the infusion. In kidneys, accumulation was greater in the presence of active infection (P < 0.01), while in lungs, accumulation was lower (P < 0.02). Infection of the lung or urinary tract had no effect on drug delivery to uninvolved tissues. Also, there was no difference between the results obtained at the beginning and the end of therapy. Overall, peak concentrations of drug many times the MIC at which 90% of the infecting organisms are inhibited (MIC90) were achieved in the kidneys (> 30 micrograms/g), prostate glands (> 11 micrograms/g), and lungs (> 14 micrograms/g). Plateau concentrations (2 to 8 h; given as mean micrograms per gram +/- standard error of the mean) of drug in kidneys (15.11 +/- 0.55), prostate glands (5.08 +/- 0.19), and lungs (5.75 +/- 0.22) were also well above the MIC90 for most relevant pathogens. All patients had a good therapeutic response to fleroxacin.

Acute Disease↗
PubMed1996

Serum-sickness-like reaction associated with minocycline therapy in adolescents.

OBJECTIVE: To describe a serum-sickness-like reaction in five adolescents treated with minocycline. CASE SUMMARY: Five adolescents developed a rash and arthralgias/arthritis after taking minocycline for 10-30 days. Symptoms resolved gradually after the medication was stopped. DISCUSSION: Serum sickness is not described in the pharmacology literature as an adverse effect of minocycline, and in the English literature there are only two case reports. The migration inhibitory factor assay and mast cell degranulation test were positive in four of the five patients. The results of these assays were consistent with a role for minocycline in causing these reactions. CONCLUSIONS: Clinicians should be aware of the possibility of serum-sickness-like reaction as an adverse effect of minocycline.

Adolescent↗
PubMed1996

Evaluation of cerebral pharmacokinetics of the novel antidepressant drug, BMS-181101, by positron emission tomography.

BMS-181101 is a novel antidepressant drug that is currently under clinical investigation. The goal of this study was to evaluate the pharmacokinetics and receptor binding of this agent in the brains of healthy human volunteers. BMS-181101 was radiolabeled with 11C by methylation with [11C]CH3I of the 5-hydroxypiperazine precursor and the product was purified by high-performance liquid chromatography. Cerebral pharmacokinetics of [11C]BMS-181101 were studied by dynamic positron emission tomography imaging in six healthy volunteers. Two studies were performed in each subject. For the first study the subject was injected with 10 mCl of high specific activity [11C]BMS-181101 (approximately 1700 mCi/mumol) and serial positron emission tomography images and arterial blood samples were collected over 90 min. Thirty minutes after acquiring the final image, each subject was coinjected with a second dose, 10 mCi of [11C]BMS-181101 plus 3 mg of unlabeled drug (final specific activity approximately 1.5 mCi/mumol), and imaging/blood collection was repeated. The data were analyzed by calculating regional tracer accumulation (percent injected dose/g) at 60 min after injection and compartmental modeling. Measurements of percent injected dose/g yielded similar values for all brain regions, independent of specific activity. Kinetic modeling of time activity curves for cerebellum, caudate, putamen, thalamus, pons and temporal, occipital and frontal cortex demonstrated that tissue distribution can be described by a simple two-compartment flow model. Statistical comparisons of the apparent distribution volumes for each region failed to reveal significant differences between the high and low specific activity studies. These results indicate that the central nervous system distribution of [11C]BMS-181101 is dominated by blood flow and significant receptor-specific localization does not occur in any brain region.

Adult↗
PubMed1995

Contribution of class I HLA-A2 antigen in immune reactions.

The involvement of the Class I HLA-A2 antigen is briefly reviewed in relation to allograft rejection, the feto-maternal relationship, viral cytotoxic reactions and tumor immunity. It is suggested that the HLA-A2 molecule may have, as compared to other HLA Class I alleles, a dominant role as a restricting element in cytotoxic T-cell recognition in the feto-maternal relationship to male fetuses, in specific viral infections and in tumors. As compared to other HLA Class I alleles, its reduced expression or loss in a variety of tumors suggests its possible important role in tumor immune surveillance. The disappearance of HLA-A2 from tumor cells may eventually contribute to the escape from T-cell recognition of malignant cells.

Cytotoxicity, Immunologic↗
PubMed1995

Synthesis of a 11C-labeled NK1 receptor ligand for PET studies.

Changes in substance P (SP) receptor concentration have been implicated in neuropsychiatric disorders, Parkinson's disease, arthritis, inflammatory bowel disease and asthma. Since, SP and peptide analogs are rapidly metabolized and do not penetrate into the CNS, they are not useful for PET. Recently, a non-peptide SP antagonist, (+)-(2S,3S)-3-(2-methoxybenzylamino)-2-phenylpiperidine (CP-99,994) was developed. As a prelude to PET studies, this compound was radiolabeled with 11C and biodistribution was determined in hamsters. CP-99,994 was radiolabeled by methylation of tert-Boc, desmethyl CP-99,994 with 11CH3I followed by deprotection and HPLC purification. The time required for the synthesis was 40 min from the end of bombardment. Radiochemical purity of the final product was > 95% and specific activity was routinely > 1000 mCi/mumol [EOS]. The biodistribution of 11C-CP-99,994 was determined in groups of six Syrian hamsters at 5 and 30 min after injection. The results of these studies demonstrated that significant concentrations (%ID/g +/- SEM) of CP-99,994 accumulate in most tissues of the hamster. The highest levels of drug were detected in the lung: 21.04 +/- 1.26 (5 min) and 13.49 +/- 1.71 (30 min). Brain accumulation was: 1.44 +/- 0.06 (5 min), 1.32 +/- 0.05 (30 min). These results indicate that 11C-CP-99,994 can be prepared in high purity and specific activity. This new radiopharmaceutical may be useful for studying both central and peripheral SP receptors by PET.

Animals↗
PubMed1994

Synthesis of [11C]dapoxetine.HCl, a serotonin re-uptake inhibitor: biodistribution in rat and preliminary PET imaging in the monkey.

[11C]Dapoxetine.HCl, S-(+)-N,N-dimethyl-a-[2-(naphthalenyloxy)ethyl] benzenemethanamine hydrochloride, a potent serotonin re-uptake inhibitor was prepared from its mono-methyl precursor, S-(+)-N-methyl-a-[2-(naphthalenyloxy)ethyl]benzene methanamine hydrochloride. Biodistribution was determined in rats at 5, 30 and 60 min after injection and preliminary PET studies were performed in a Rhesus monkey. 11CH3I was bubbled into a solution of S-(+)-N-methyl-alpha-[2-(naphthalenyloxy)ethyl]benzene methanamine hydrochloride (3.0 mg in DMSO) and the mixture was heated at 110 degrees C for 8 min. [11C]Dapoxetine.HCl was purified by HPLC on a C18 cartridge eluted with MeOH:phosphate buffer, pH 7,2 (75:25) with a 10% yield (end of synthesis). The time required for the synthesis was 40 min, from the end of bombardment. Radiochemical purity of the final product was > 99% and specific activity was routinely > 400 mCi/mumol [EOS]. In the biodistribution studies the highest concentration (%ID/g +/- SEM) of dapoxetine.HCl was detected in lung: 4.56 +/- 0.27 (5 min), 1.28 +/- 0.18 (30 min) and 0.67 +/- 0.04 (60 min). Brain accumulation was 0.76 +/- 0.02 (5 min), 0.46 +/- 0.04 (30 min) and 0.27 +/- 0.01 (60 min). Preliminary PET studies demonstrated significant displaceable binding in the cerebral cortex and subcortical grey matter. These results demonstrate that [11C]dapoxetine.HCl can be prepared in high purity and may be useful for the in vivo evaluation of serotonin re-uptake mechanisms.

Animals↗
PubMed1994

Erythema multiforme and hypersensitivity myocarditis caused by ampicillin.

OBJECTIVE: To report a case of erythema multiforme and hypersensitivity myocarditis caused by ampicillin. CASE SUMMARY: A 13-year-old boy was treated with ampicillin and gentamicin because of suspected septicemia. Medications were discontinued when erythema multiforme and congestive heart failure caused by myocarditis occurred. The patient was treated with methylprednisolone and gradually improved. Macrophage-migration inhibition (MIF) test with ampicillin was positive. DISCUSSION: After most infections causing erythema multiforme and myocarditis were ruled out, a drug-induced allergic reaction was suspected. Positive MIF test for ampicillin showed sensitization of the patient's lymphocytes to ampicillin. CONCLUSIONS: Hypersensitivity myocarditis is a rare and dangerous manifestation of allergy to penicillins.

Adolescent↗
PubMed1994

Myocardial extraction of 1-[11C] betamethylheptadecanoic acid.

UNLABELLED: Betamethylheptadecanoic acid (BMHA) is a branched chain fatty acid analog that is transported into myocardial cells by the same long chain fatty acid carrier protein mechanism as natural fatty acids, but cannot be completely catabolized and accumulates in the tissue. Thus, 11C-labeled BMHA is a useful tracer for the noninvasive evaluation of myocardial fatty acid utilization by positron emission tomography (PET). METHODS: As a prelude to PET studies, the metabolism of BMHA was studied by classical techniques. We measured the net extraction fraction (En) of 1-[11C]-beta-R,S-methylheptadecanoic acid (1-[11C]BMHA) and compared it to that of natural fatty acids in dogs, using arterial/venous measurements and a mathematical model. Two groups of conditioned dogs were studied. In the first group, measurements were made under fasting (normal control) conditions and in the second group, measurements were made during glucose and insulin infusion. Myocardial blood flow, and the extraction/utilization of other substrates (glucose, oxygen and lactate) were also measured. RESULTS: For natural fatty acids in the basal state, En(FA) was 0.335. After glucose/insulin infusion, this value decreased to 0.195. The 1-[11C]BMHA showed a similar decrease in En(BMHA) from 0.220 in the control group to 0.100 in the group treated with glucose/insulin infusion. Preliminary PET studies with 1-[11C]BMHA verified the validity of performing these measurements noninvasively. CONCLUSION: The results of these studies indicate that rates of fatty acid metabolism in the myocardium can be determined from steady-state concentrations of 1-[11C]BMHA.

Animals↗
PubMed1993

Pharmacokinetics of fleroxacin as studied by positron emission tomography and [18F]fleroxacin.

A new method of tracing the disposition of fleroxacin was tested in infected and noninfected animals in an effort to develop a technique that might be applicable in humans. [18F]fleroxacin was synthesized and shown to be identical physically, chemically, and in its antimicrobial activity to the commercially produced product. Tracer amounts of [18F]fleroxacin were coinjected with a pharmacologic dose of unlabeled drug (10 mg/kg) into normal mice, rats with focal thigh infection due to Escherichia coli, and normal and infected rabbits. The rats and mice were killed at fixed time intervals after injection, and the concentration of drug was determined by radioactive counting in a well-type counter; the rabbits were studied both by this method and by positron emission tomographic (PET) imaging. These studies validated the reliability of the new approach and suggested that it could be applied safely to humans. In all three animal species studied, delivery of [18F]fleroxacin to most tissues was rapid, with the notable exception of the brain. Accumulation of drug in infected thigh muscle was similar to that in normal muscle. The concentrations of drug reached in various tissues suggest that fleroxacin will be particularly useful in the treatment of gastrointestinal, urinary tract, hepatobiliary, and skeletal infections and that it shows promise for the treatment of lung and soft tissue infection. The minimal concentrations of drug delivered to the brain should decrease the occurrence of central nervous system toxicity with this particular fluoroquinolone.

Animals↗
PubMed1993

[Pityriasis rosea-like eruption after anti-inflammatory and antipyretic medication].

We report 2 cases of a pityriasis rosea-like eruption after the use of the anti-inflammatory and antipyretic medications naproxen, acetaminophen, and a combination of acetylsalicylic acid and codeine phosphate. The role of these drugs in the induction of the eruption was supported by the results of macrophage migration inhibition factor and mast cell degranulation tests performed on the offending drugs.

Adolescent↗
PubMed1993

Distortion in the parental transmission of HLA-A2 haplotypes (locus A,B).

The parental transmission of HLA-2 antigen in association with the epitopes BW4 and BW6 (class I HLA haplotypes locus A,B) was analyzed in sons and daughters from 42 families in which one of the parents carried the HLA-A2 antigen. When the parental transmission of A2 BW4 and A2 BW6 was compared, it was observed that a significantly higher number of siblings inherited the haplotype A2 BW4 from the paternal than from the maternal haplotype. Although the number of cases is small, the mode of inheritance of haplotype A2 BW6 was completely different. The genetic distortion in the transmission of HLA-2 BW4 and HLA-2 BW6 was observed in children of both sexes.

Cytotoxicity, Immunologic↗
PubMed1993

Synthesis and biodistribution of 18F-labeled fleroxacin.

[18F]Fleroxacin (6,8-difluoro-1,4-dihydro-1-(2-[18F]fluoroethyl)-4- oxo-7-(4-methyl-1-piperazinyl)-3-quinolinecarboxylic acid) was synthesized from its methylsulfonyl ester precursor. 6,7,8-Trifluoro-4-hydroxyquinoline-3-carboxylic acid ethyl ester (Ro 19-7423) was alkylated with 2-bromoethanol to produce 6,7,8-trifluoro-1,4-dihydro-1-(2-hydroxyethyl)-4-oxo-3-quinolinecarboxyl ic acid ethyl ester in 76% yield which was then condensed with 1-methyl-piperazine to produce 6,8-difluoro-1,4-dihydro-1-(2-hydroxyethyl)-7-(4-methyl-1-piperazinyl)4- oxo-3- quinolinecarboxylic acid ethyl ester in 67% yield. This product was reacted with methanesulfonyl chloride to produce the mesylate precursor of fleroxacin in 66% yield. Nucleophilic substitution of the mesylate with 18F- in the presence of Kryptofix 2.2.2 followed by basic hydrolysis produced [18F]fleroxacin with a radiochemical yield of 5-8% [EOS] within 90 min. The pattern of biodistribution of [18F]fleroxacin was similar to the 14C-labeled drug.

Animals↗
PubMed1993

Mode of inheritance of HLA haplotypes locus A,B in siblings of different sexes.

METHOD: Forty-eight parents and 172 children were typed for class I HLA antigens, locus A,B. RESULTS: Although the number of cases is small, we observed: (1) a significantly decreased number of sons born after a first delivery of a son, as compared to a first delivery of a daughter; (2) significantly increased sharing of maternal class I HLA antigens between the firstborn son and his brothers from higher birth orders, as compared to his sisters; and (3) HLA-A2 antigen, which is known to be involved in HLA restricted cytotoxic reactions in the recognition of minor histocompatibility antigens, was inherited in subsequent deliveries of sons as compared to daughters in a significantly higher frequency from the paternal than from maternal HLA haplotype. The results suggest that sharing of identical maternal HLA haplotypes between brothers may aid to decrease the degree of maternal sensitization to fetal antigens, and lack of HLA-2 antigen in maternal cells from sons as compared to daughters may avoid maternal HLA-A2 restricted cytotoxic reactions toward the male fetus.

Adult↗
PubMed1993

Treatment of recurrent spontaneous abortions by immunization with paternal lymphocytes induces immunosuppression by placental isoferritin.

PROBLEM: The immunological mechanism leading to an effective vaccination of unexplained habitual aborters with paternal lymphocytes is not yet elucidated. Since previous studies revealed that immunosuppression by placental isoferritin (PLF) may play an important role in the down regulation of the immune system during pregnancy, it was of interest to investigate whether alloimmunization activates immunosuppression by PLF. METHOD: The immunosuppressive effect of PLF or anti-PLF CM-H-9 monoclonal antibody (MAb) was studied by a one-way mixed lymphocyte reaction (MLF) of alloimmunized women and their husbands. RESULTS: It was found that vaccination of the women with paternal lymphocytes resulted in in vitro immunosuppression by PLF as well as by CM-H-9 MAb, reaching the highest effect after three vaccinations (38 +/- 8 and 42 +/- 10%, respectively). The increase in PLF immunosuppressive effect was accompanied by the appearance of serum antipaternal human leukocyte antigen cytotoxic antibodies. However, there was no correlation between the degree of suppression and titer of antibodies. The study group was too small to reach a significant correlation between degree of immunosuppression and pregnancy outcome. CONCLUSIONS: Although it may be of value to measure the inhibitory effect of PLF in one-way MLR as an index of immunosuppression, further studies are needed to establish whether it is a relevant predictor of a successful pregnancy.

Abortion, Habitual↗